Temporal summation of repetitive click stimuli

Monaural loudness balances were performed by eight normal-hearing subjects to determine the effect of click repetition rate on loudness sensation. Click trains of 500 msec duration were matched in loudness to a standard 500 msec 1000 Hz tone burst presented at three reference loudness levels (70, 80, and 90 phons). Click trains were presented at repetition rates of 11, 31, 51, and 91 clicks per sec. It was found that click trains at faster repetition rates required lower intensities for judgments of equal loudness sensation. This finding was attributed to the process of temporal loudness summation. The magnitude and nature of the temporal summation process as well as the influence of the reference loudness level are discussed.     

Quality of life and mechanical heart valve sound

Most currently used mechanical heart valve prostheses generate a distinct metallic sound at closure. Since this sound is often well audible to many patients it can significantly affect their quality of life after heart valve replacement. In this study of surviving patients after heart valve replacement with three types of Bj?rk-Shiley valves (Shiley Inc., Irvine, Ca) one third of the patients claimed that they were in certain situations disturbed by the sound. Several factors were found to be of importance for the perception of mechanical heart valve noise, including age, sex, location of valve, configuration of the thorax, hearing ability and environmental background noise. Preoperative patient information can be of vital importance to avoid postoperative adverse patient reactions.     

Clinical significance of renal hemodynamics in severe congestive heart failure: responsiveness to ultrafiltration therapies

Isolated ultrafiltration, hemodialysis & peritoneal dialysis (Tx) were recently used in the treatment of intractable heart failure (HF). We examined the relation between the response of HF to Tx and the residual kidney functions. Tx was carried out in 17 patients (Pts) with HF who did not respond to aggressive medical treatment. Ten Pts (R) responded to Tx and 7 Pts (N) did not. Serum urea nitrogen (UN), creatinine (Cr), uric acid (UA), sodium (Na), potassium (K), and chloride (Cl) concentrations on admission and before Tx were not different between R and N. Urine UN, Cr, Na, K, and Cl on admission and before Tx were also not significantly different. Fractional sodium excretions (FENa), renal failure indices (RFI), and urine/plasma Cr ratios (U/P Cr) on admission were 2.0 +/- 1.6, 2.7 +/- 2.2, and 30.5 +/- 20.0 in R and 5.9 +/- 4.2, 8.2 +/- 6.0 and 11.5 +/- 3.8 in N. They were significantly different (p less than 0.05). However, these did not differ before and after Tx. These data show that FENa, RFI and U/P Cr might be useful indices in predicting the responsiveness of intractable HF to Tx.     

Occupation and bladder cancer in Spain: a multi-centre case-control study

A case-control study on bladder cancer was carried out in four regions of Spain. The study included 497 cases (438 males and 59 females), 583 hospital controls and 530 population controls matched by sex, age and residence. The present paper reports the results of the analyses on occupational history. Among men, an increased risk of bladder cancer was found for textile workers (OR = 1.97, 95% CL 1.2-3.3), mechanics and maintenance workers (OR = 1.86, 95% CL 1.2-2.8), workers in the printing industry (OR = 2.06, 95% CL 1.0-4.3) and for managers (OR = 2.03, 95% CL 1.2-3.5). The risk was highest among those first employed in the textile industry before the age of 25 and prior to 1960. Among mechanics the risk was highest for those who started after the age of 25 and later than 1960. The OR for smokers who had also been employed in one of the high risk occupations was 7.82 (95% CL 4.4-14.0) which is compatible with a multiplicative effect of joint exposure to tobacco and occupational hazards.     

Epidemiology of acute diarrhea in children living in Sicily

A longitudinal survey (February 1984 - January 1985) on the incidence of acute diarrhea episodes in a sample of 8,164 children (aged 0–12 years) living in southeastern Sicily was carried out by means of weekly telephone interviews with doctors practising in the territory. The incidence rate was 0.479 (0.472–0.485 95% C.I.) per child per year and the frequency of episodes was significantly higher (p < 0.001) in children aged 0–4 years (0.86). Diarrhea was more frequent in industrial areas than in rural ones, and almost half (45.1%) of the total episodes had a mild course. No death from diarrhea occurred and admission to hospital was reported for 8.4% of all cases.Corresponding author.     

SPECT gallium scanning for lymphoma and infection

Thirty gallium scans, using currently acceptable dosage levels (5-6 mCi) and a conventional rotating gamma camera, were performed on 20 patients with lymphoma or infection. Compared to planar scans, SPECT increased sensitivity and lesion detection from 48% to 89% in lymphoma, and from 50% to 80% in infection. The predictive value of a negative site was 81% in lymphoma and 67% in infection. Gallium utility is markedly increased by SPECT imaging. A normal gallium SPECT scan is highly accurate in ruling out disease.     

Health maintenance issues of the elderly. Nutrition

Although we are on steep learning curve as far as the exact relationship between nutrition and disease prevention is concerned, evidence is accumulating on the role of body mass index and mortality, protein deficiency and decreased ability to fight infection, effect of fiber intake on cholesterol and glucose metabolism, hyperlipidemia and atherosclerosis, and inadequate calcium intake in osteoporosis. Screening for nutritional disorders includes identifying those with risk factors of being female, black, poor, or institutionalized. Evidence of weight change, dietary idiosyncracies, nutrient deficiency, and laboratory tests can be helpful. Treatment should be tailored to the individual and be specific for suspected deficiencies. Attention to calories, protein, and calcium are paramount.     

Effect of ischaemia on somatosensory evoked potentials in diabetic patients.

The nerve action potential at the elbow and somatosensory evoked potentials (SEPs) at the scalp were recorded over 30 minutes of tourniquet-induced limb ischaemia in 10 diabetic patients and 10 controls. According to the SEP changes, an increased resistance to nerve ischaemia in diabetic patients was observed. The pathways involved in SEP conduction are discussed.